Contract Details
CapacityLAB, LLC
Facility name
CapacityLAB
Provider ID
P000000001
NPI
1245837335
Tax ID
851171198
Effective Date
11/19/2020
Last Updated
11/23/2020
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
450 Century Park South Suite 103A
Birmingham, AL 35226
United States
Phone
205-968-1616 (Phone)
Billing Details
Address
450 Century Park South
Suite 103A
Birmingham, AL 35226
Billing Phone
205-968-1616
Specialty Type
Physical Therapy
Website
Visit Website
Workers Comp Coordinator
Jill
Page
jillpage@gmail.com
Map
Address